Takeaway
- Treatment with concurrent chemoradiotherapy (CCRT) led to a better objective response rate (ORR), PFS, and OS than chemotherapy alone in patients with stage IV esophageal squamous cell carcinoma (ESCC).
Why this matters
- Current NCCN guidelines recommend chemotherapy and/or palliative therapy alone in this population.
- CCRT is standard of care for inoperable, locally advanced esophageal cancer, but its benefits and toxicity in other groups is not well known.
Study design
- Retrospective analysis of 141 (55 CCRT; 86 chemotherapy only) patients at a single center who were treated from January 2010 and October 2015.
- Funding: Wu Jieping Medical Foundation.
Key results
- ORR: 74.5% CCRT vs 45.3% chemotherapy (P=.001).
- Disease control rate: 94.5% CCRT vs 80.2% chemotherapy (P=.024).
- CCRT improved OS vs chemotherapy alone (P= .007) at 1 year (58.0 vs 43.0%), 2 years (25.5 vs 14.0%), and 3 years (10.7 vs 4.7%).
- CCRT yielded improved 1-year and median PFS (29.8 vs 14.9%; 8 vs 6 months; P= .005).
- Multivariable Cox model showed CCRT as a predictor of longer OS (HR, 0.631; P=.013).
- CCRT was associated with a higher rate of grade ≥3 leukocytopenia (41.8% vs 24.4%; P=.040).
Limitations
- Chinese population.
- Monocentric, retrospective design.
- Single institution.
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